If people are so concerned about the size of their penis then they should not have the RP and go with radiation that effects other internal organs. If my penis is 1 or 2" shorter due to surgery but I am cancer free that is a small price to pay. I never went around showing my member off to other people anyway so nobody know accept my wife & I. If the length of your shaft is that important then you have other problems. My wife is happy just to have the cancer gone, we all have to make choices.

No one can expect a fair answer from a doctor in regards to the quality of life post therapy. They only treat and that includes their specialty or business interests. The following two links comparing surgery against radiotherapy and vice versa are evident demonstration on the issues involved. While the radiologists take the side effects into consideration the "Counterpoint"-by an urologist focus on the treatment outcome. Interesting indeed;

It has been 11 years since my diagnosis and RP surgery. Quality of life has been the central struggle and challange during this period. My doctor all but assured me that I only had a 5% chance of being incontinent or impotent. Well, it turned out that the 5% was in fact 100% as it relates to impotence; however, incontinence is very mild but does exist. I didn't hide from life. I tried every form of ED treatment I could afford, and I have even seen a therapist regularly for 10-years. The failed relationships, male identity crisis, fear of rejections, and vulnerability were a constant. I have recently begun adjusting to a life without female relationships. I had surgery at age 47. I was very young and uninformed. I firmly that my doctor was too cavalier with my life. I felt violated and cheated by him. It seemed almost criminal. But what can you do after the fact? I had to find a new normal. It took me 11 years. It was a very, hard and long road. I did prevail not because of, but in spite of, the doctors. I will give special credit to my therapist. She specialized in body trauma. I am not sure that I could have made it this far without her kind ear.

. . . that radiation treatment provides the least risk and greatest probability of a better quality of life following treatment for PCa.

I have been pounding my keyboard repeatedly trying to make this known to newbies who have logged on here over the past 7 years following my treatment with CK, which is the best method of radiation treatment currently available IMO.

It's not that the are no risks from radiation. There are but they pale in comparison with the potentially life-altering risks presented by surgery which not only include the shortening of the visible penile length but also the possibility of permanent ED and incontinence, as MK1965 so awfully discovered.

My message to newbies has simply been, why subject yourself to the risks of surgery when a potentially less draconian and equally successful method of treatment -- namely radiation -- is available?

When I had to make the choice, I decided that there was no reason take such a risk and fortunately some men have made a similar choice based on my advice. I just wish that MK1965 had also been one of them.

I've been reading on this site for a number of months, and researched. I also belong to another forum which I have been more active. This post lead me to create an account and post.

I have read many stories of issues after RP, as well as good outcomes. They concenred me to an extent during my decision process this past summer. However, as in most Internet sites, whether Amazon or Forums, I think people with issues tend to be more vocal and sound alarms to protect others. All in all a great thing. However, with my diagnonsis June 2017, I was able to talk with people around my core set of freinds adn their faimily members who directly had prostate sugery and radiaiton. I put as much stock in their opinions, and maybe more, than those I read online. All but one I met face to face had RP. All but one had near-zero issues a few months after surgery and retuned to a very active normal life. The one with issues had regrets, but did not vocalize he wished he had been treated differently. The only one treated with radiation had wished he had surgery, he was at the 5 year mark. He was better early on, but his incontinence issues had been continually degrading quickly. He was really down. It was a very small sampling of 5 people. I write this only as my pesonnal reference tot me as you read on.

I met with three good surgeons. First Open Sureon, I don't recall a reference to penis length. The second an RP sureon as he explained the surgery talked about the removal. As he told me they would remove the prostate by snipping the urethra at base and apex and then stitch urethra and bladder togther, I immediately visualized the process. I asked him which end makes up the loss. He chcukled and told me it was a good queston, "either the bladder drops a bit, or yes the penis will be shorter". I had my answer. Never asked surgoen number three but didn't need to, but he made a quick comment about it.

End of August 2017, I had my RP. Catheter removal after 2 weeks and I had zero issues with incontinence once removed, not a drop. Mayo gave me a #4 huggies as a pad on the drive home, it was dry all day. Wore a diaper two nights just in case, was never wet in the morning. Woke once each night to pee. After the second night, never used one again, and never used a pad since the drive home from the hospital. My story more closely aligned with the people I talked to then what I read on the forums.

I have no real ED issues. Still not 100%, but it's better thatn 80% and I figure in a year it'll be closer to 95%. When I step out of the shower, is my littel buddy shorter? I'd say most mornings he seems to be, but not always. When erect, I'm not so sure, I haven't really noticed a difference.

Tens of thousands of men have this surgery. Hundreds are active on these forums. Probably the same percentage as the few I talked to compared to those I comminucate to on a forum.

My advice to friends as they age wth me, as they may have prostate issues, will be the same as I state here. Research your options fully, make the decisoin you feel right is for you and hope for a cure and be ready for side effects in teh short and long term. But I wil let them know how it worked for me.

One more note, it is hard to post a great success story as I read others with not so good outcomes. It is why I tend to stay silent, read and continue to learn for me only. But I do want people to know this surgery does and can work very well. I don't believe I am a small minority. I think all of this ties into your overall health going in, the agressiveness and stage of your cancer, and the size of your prostate ties into this at surgery time. OH!! and without a doubt, the skill of you surgeon.

I was a diganosed 4+3. Pathology downgraded to 3+4, small margin of <.1 cm and my very recent first post-op PSA at 90 days was <.04

Good to hear you had a sucessful outcome from your RP. Very good story on your RP journey, sounds like you did your research and made your choice. According to MK1965 & Swing, you & I must be the only two people within five galaxies that have had a success. That's why I have always said to get the best doctors & hospitals for any type of cancer treament, surgery or radiation. And oh by the way my penis still seems to be just about as long as before, but then again I never was obsessed about the length of my member. Surgery is a good and viable option with a lot of good sucess stories, the same goes for the various forms of radiation treatments. We should be able to come to this forum and get realistic, honest facts and real life experiences and not scare tactics who favor one form of treatment over another. Do you research and pick you choice based on facts and not someones biased opinion.

I had my RP performed by Dr. Patel at Florida Hospital 8 years ago last month. Pre surgery gleason 4 + 3=7 post 5 +4= 9. No ED problems after the first year, penis size is the same as before surgery. As far as incontinence I had issues before cancer diagnosis, many surgeries with multiple catheters which caused a lot of scar tissue. Dr Patel even told me that before they could insert the catheter in the operting room for my RP they had to do a roto rooter job. A few months ago I had a AMS 800 artificial spincter surgery since it got really bad this last year but I don't attribute it to the RP. I agree the problem is you need to go to the very best surgeons with the most experience if you expect good outcomes. Everyone that I know that had seeds or radiation around the same time I had my rp are dead.

In this thread it is so good to hear from at least one other guy who has had to deal with SERIOUS PATHOLOGY. I will forever remember his quote... Everyone I know that had seeds or radiation around the same time I had my RP are dead. And here's another one for you... "Dead men have no erections"... and apparently neither do men on Lupron.

For the rest of you, I have to ask, where the heck are your priorities?!! If the size of your penis is your greatest concern, then as someone else noted, you have problems elsewhere to deal with.

As I read this thread I just shake my head. Going into my fifth year battling high risk prostate cancer, I can't help but be amazed at where your heads must be. You should consider yourself fortunate if you had a '3' appear in your path report. And realize that without an RP, you would not even HAVE a pathology report. Likewise if you had a single digit PSA, or if your cancer was detected on the first biopsy, if you even qualified for something like Cyberknfe or heck, even if your doctor took you seriously when your symptoms first appeared.

Now I've had both an RP plus eight weeks of daily radiation and I'm still on Lupron, plus cannot pee without first squeezing the bulb in my scrotum. The proctitis and frequent diarrhea brought about by the radiation is the worst side effect that cannot be dealt with, uh, mechanically. Given the opportunity to go back and change anything, it would be to have had the surgery much sooner, and none of the rest would likely have been necessary. And now the scars from my RP and AUS surgeries join the rest of the no less than sixteen surgical scars on my body.

So if you're griping because your tiny weenie got an inch shorter, MAN UP. And pray that this is the worst health problem you will ever have to face in your lifetime.

I have followed MK's posts since my diagnosis and can understand his concerns. Prior to surgery I was low-risk, low volume Gleason 6. I was concerned about ED, incontinence and size but wanted to be aggressive and went ahead with RP. The good news was that I emerged with no ED, no incontinence, and perhaps a minor, hardly noticable reduction in size. But the bad news is that I still have cancer. First PSA was .40 and now I'm scheduled for Salvage Radiation and have had the Lupron shot.

Everyone's experience is different. It's understandable to be upset about ED and loss of size. I'd rather worry about those things then about arresting the cancer. It's like there should really be two Forums....one for those who are continuing the battle with cancer and one for those who have had success against PCa but are dealing with side effects.

The main objective for me was to get rid of the cancer in the cleanest way possible with the least amount of side effects. I chose Davinci RP and have no ED after 3 yrs. and just a small stress leakage. I can live with the one side effect as long as the cancer is gone. I keep hoping for more un detectable readings. People have chosen radiation with similar results and thats fantastic. I really feel sorry for MK1965, but I would sacrifice my sex life any day to be rid of prostate cancer.

The problem with the notion of 'two forums' here is that the two issues -- eradicating cancer, and dealing with side-effects, are inseperable. Either inevitably affects the other.

My daughter sent me some pictures today off of a camara she had found. There were several of my dead friend Gary, who died of PCa in around November of 2013, after 13 years of fight. They are now the only photos that I have of him. Gary did it all: RP, 45 doses of IMRT, years of HT, Taxotere (chemo), and then the new castration-resistantHTs (Jevtana, Zytiga). The IMRT ulcerated his colon, and he had to have surgical cauterization of his colon periodically. Profound dehydration was his immediate cause of death, how the cancer killed him. Water poured out of him like there was nothng between the mouth and the rectum.

Nonetheless, 12 of those years were (mostly) good years. Gary worked almost full time (despite being retired as an engineering manager), and was extremely active with his antique cars. Lots of girl friends (meaning friends who were girls). He was always on the go, and never bitc--d about anythnng; no griping. I was with him most of his last year, since his family all lived out of state. I went to all of his oncology appointments and treatments, and learned a great deal from the NPs. It served me well, when 1.5 years later, I got diagnosed with PCa myself. I have known many other men who had had RPs. None ever voiced a complaint, ever. Two others died eventually also (one only in his late 40s). All were thankful of life, however, and did say THAT.

Gary's last 4 months or thereabout were horrible, I will spare the details. When you watch a man die of PCa, you will know that having cancer is worse than side-effects. Every time.

When I met my friend, a Radiation Oncologist, to discuss using RT against my disease, he said "Rationally, any man approaching this will have 3 priorities, and in this order: (1) eradication of the disease, (2) continence, and (3) potency. This is a logical, rational assessment, not an emotional one, or one based upon individual preferences. I latched on to is statement, since it was a conclusion I had already reached myself.

Rob Lee above made a brilliant statement about side-effects being less serious (to a sane individual) than death: Dead men don't have erections. That reminds me of a slogan I have held to for years: I'd rather have side-effects than have cancer. The two are always interrelated. Any man who believes he has no cancer following successful treatment must recall that relapse can happen to anyone, even to a man following seemingly complete cure. Many writers here describe relapse 10 years or more after zero PSA. The same post-RT....YEARS later.

Cure is always Job 1. And Cure is reason for complete thanksgiving.

Most men here are close to natural impotence anyway. I read an occasional 70-something complaining of it, and shake my head. They would most likely be impotent by their age without any PCa having ever occured. It is tragic when it happens to a man in his 50s. But it is not death. I've looked at death many times, and it is not death. My mom grew up during the Great Depression in the Deep South; people starved to death. She used to have a saying, "I regretted having old shoes, until I met a man with no feet."

you two are my biggest opponents on this forum and never supported or agreed to anything I posted. OTOH, you guys are trying to make me mentally incapable. All what I am trying to voice here is that surgery ruiNed my life at the age of 51.

Based on my experience, I don’t beleive giving men the odds of success is helpful. I believe informing a pre-surgery patient that he could experience a complete loss of erectile function is more realistic.

I also believe that men who experience the loss of erectile functioning after surgery should receive follow up with a healthcare professional until is known where he landed post surgery and it should take for a minimum of three years.

In most cases recovering from RP takes a few weeks. Recovering from side effects and QoL issues brought on by RP, takes a lifetime.

No one prepares you for this reality before surgery.

Death and daing is not pleasenth situation neither for daing nor others who are loosing loved ones. I saw it all in medical and surgical ICU and it was work related. Thanks God for my last15 Year’s being away from bedside and working from home comfortably from my own office.

As I said many times, I will never be satisfied with RP even if I would wake up tomorrow with raging

erection. I already suffered enough with SE and now even my marriage is on the cliff and very shaky.

If I never had RP, I would save myself from all of thise and still would live comfportably with Ca in me. QoL was always my priority.

I already acommplished in my life what I planned to. Death is not worse then being alive and not be able to do what you did yesterday.

I don't see myself as an opponent of anyone on this forum. Just trying to get the truth out so people can make an informed choice by what they read here. They can see your surgery did not go well but others have had surgeries that did go well. People need to read both sides so that they can make an informed decision on their path. Your last line "I already acommplished in my life what I planned to. Death is not worse then being alive and not be able to do what you did yesterday." really troubles me. I think that this road you are going down is not a good one. I wish you would please seek professional counceling for you to get through your anger & depression. Sorry to hear that this has caused marital problems, that does not help the situation.

First off I must apologize for the tone of my earlier post above. I promised myself that I would not post when feeling like a cynical old man, but I did and it came off sounding both bitter and insensitive. But please understand that I do not regret the RP at all, eventhough it has changed my life dramatically.

The decision to get the AUS and thereby altering how I must do something that we all do all day, every day for the rest of my life was a more difficult decision than was the RP. And the decision to remain on HT for the time being was also not taken lightly, especially since the outcome of the HT+RT will not be known for at least another year from now. And the SE's of the HT plus the emotional trauma of battling cancer since early 2014 now has me taking antidepressants, for the first time ever, and probably for the rest of my life. None of this was easy, but it DID save my life as well as my marriage and I will never forget that.

Yes, the surgeon saved my life. My wife and I DID consult with RO's and chose surgery for a varrety of factors. I will spare the details here, but will also add that my experience with the RP and the surgeon who performed it was the most favorable experience of the dozen or so surgeries that I've ever had... and I say this even in light of the fact that it left me both incontinent and impotent and STILL required a full course of radiation a year later.

So yes, I know what it is like to have had a bad experience with illness or injury and especially surgery, and the lasting effects they can have on your psyche as well as physical abilities and emotional well being. I have been bitter about the outcomes of my own experience with surgeons. But that bitterness affects one's self more than anyone else. And it takes time - years - to get over it. The anger eats away at you from the time you wake up til you finally drift off to sleep, emotionally exhausted.

But eventually you realize that you made the best decision you could at the time and given the information you had at that time. You can't go back and change ANY of that. Guilt and regret will haunt you until you accept that any other course of action could have potentialy had far worse consequences. Consider THAT as a possibility.

Thank you all for your contributions. We all suffer together, as well as hopefully help each other with our struggles.

Every day many other things are remainding me of something I should not do against my will.

Just yesterday while in gym at elliptical machine going a bit faster I started to leak that go with any excercising if I go with pre RP speeds, weights or any strenuous movents which were my typical routine. I was active all my life and I want to continue but I have to be aware of speed I can run comfortably or weights I can lift. Otherwise, my stress incontinece takes control. If I sit doing nothing I am fine, dry all day.

Changes that followed RP are dictating my life and controlling my abilities.

With 4+3 which after surgery was downgraded to 3+4 but bilateral, I could comfortably live stress free life.

To see final pathology was not important to me at all. Maybe for others that meant something but not for me.

If it would be emergent surgery for life saving, I would accept any outcome. But my surgery was elective and it was done with my consent (against my will because I wanted to do nothing, worst case scenario would be radiation) so is very hard to accept consequences.

To cut out most likely would never be to late at least in my case. And at 75, I would not care about ED and shorter penis.

At 52, my tool is very valuable to me and on second place behind my brain. To be clear, i am not in porno industry.

What you are facing is the various aspects of AGING. More diseases, weaker body, limited abilities. At age 50 I was less verile than I had been in my 30's or 40's and was less able to satisfy my wife. It was tough, and she was not very understanding at the time. But we have two well adjusted sons with their families and I can be sure that I/we raised them well. I chose to look at the positive outcomes of our relationship when my body could no longer perform as it had previously. Sex became secondary, but after we both later survived our cancers we became closer than ever.

At age 54 I was working on some wiring and fell between a truck and a wall. Because it was workers comp everything was covered, but I had nonetheless been careless and therefore nearly lost a leg. It still limits my abilites to this day. So I stuck to a desk job until age 60 when I had to inform my employer that I could no longer perform the kind of mental work that had done for most of my life. I elected to leave early before I might potentially make an error that could cost my employer financially.

Both my tool and my brain are not what they used to be.

These were all bumps along the road of life. Cancer presented yet another obstacle. I would have liked to have done a few things differently. What happened was, as I mentioned above, is that I am now essentially fully impotent and only artifiically continent. These were not the outcomes I had chosen, but were the outcomes of choices I had made when confronted with changes in my life.

It is something we all are forced to do. You can blame yourself for having chosen wrongly, but I suspect that only leads to a life of self loathing. You can tell yourself that, while you may regret the outcome, you at least did something. Doing NOTHING is always an option, but that is in itself a choice. Would you hate yourself for doing nothing, when you perhaps should have done something?

That age of 75 that you mentioned as a point when you would not care what happened, is for me now only seven years away. Thinking back to what I was doing seven years ago it seems like only yesterday, yet when I think of all that has happened in those seven years I wouldn't want to have missed out on any of it. They say that the closer you come to the end of life, the more precious life becomes. Forgive yourself for those things you could have possibly done differently and realize that you are only human. Accept that the choices you made are behind you and adapt to the outcomes. Had things gone differently, can you be certain that your life would indeed be any better?

I'm just trying to help you feel better about your life the way it is. Things are different now. Many others have been down this road. Some have had it worse than others. Consider yourself fortunate that you were downstaged to 3+4 from 4+3, and NOT gone from 4+3 to something like 4+5. It happens, and it thapppened to guys I know...Max also told the tale of his friend. In life there are no guarantees.

For the record, I was told that I WOULD have ED by a friend who had not yet recovered from his RP, but elected to have the surgery anyway. Shortly after my RP, he admitted that he had started to recover from ED about a year after his RP, and that is about the time I found this forum and read into the archives about "use it or lose it" which is what my surgeon also warned. Recovery from ED has been a bonus for me as I never expected to recover my sex life, and dealing with the issues I faced, did not care if I did.

We must be careful of what is called "The Mechanic's Fallacy" . Just because one mechanical problem exists in your engine does not necessarily mean it is the cause of the engine malfunction, no matter how coincidentally the timing. E.g. your engine won't start... So you check your battery and it is not holding a charge very well. So you change it. Engine still won't turn over. Test shows alternator not charging battery, so you change it. Engine still won't turn over. Solenoid on Started is going bad so you change it. Engine still won't turn over. So you sell car you just spent a grand on parts. Friend buys it, and puts the car in park, wiggles steering wheel... Engine starts right up.

Obvious point is: ED can be caused by interrelated issues. RP, Diabetes, stress, low T, high blood pressure, prescription medications, heart disease, etc. all can cause ED, but what is worse, they can all be nearly undetectable, but present enough to be interacting so that no one solution will solve the problem, and no one issue may be the only culprit.

I am not an RP advocate for anybody but me myself and I. It may have ruined some people's QoL but it SAVED mine. I am an advocate for the best solution for each person, and often that is RP, and sometimes it is not. But if it is proved that RP was NOT your best option, then you should take that up with your urologist, not with the guys who have had wildly successful RPs that gave them a new lease on life, and crusade against RP in all cases when there are cases where it is absolutely necessary, like mine.I

My neighbor had advanced PC that was too advanced to be treatable. He regretted not discovering his PC until it was too late to effectively treat it, as it is the silent imperceptible killer. As the disease was advancing, Paul warned all family and friends to get tested, and if necessary get treated. His widow would give ANYTHING! ANYTHING! to have him get an RP long before the PC advanced. He has been dead for a couple years now, and Frances sold the house across the street from us, and moved away. It was heartbreaking to see them go through what he endured. And heartbreaking to see her struggle with the sad memories. Maybe being away from the house where they raised their kids, and entertained their grandchildren will give her closure, I don't know, because I guess I will never see her again. I sure won't see him again.

Hold on a minute! MK you are saying your marriage is in danger because of ED?! You can't be serious! If my wife knew your wife, she would scold her for such a shallow approach to marriage!

Contrary to men's popular perception, coitus is not nearly as important to women as intimacy, affection, security, commitment, fidelity, etc. That is why you will see a gentleman's club with strippers every block in some cities, but male strippers are a rare novelty, because men and women are so different.

If your marriage, which is a commitment for better or worse, is threatened by ED, then you both need counseling. I cannot fathom that a woman would end a marriage because a guy can't get it up. Something else is going on, there has to be. Maybe I am old fashioned, but this makes no sense to me. At all. None of it.

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